The role of incapacity benefit reassessment in helping claimants into employment - Work and Pensions Committee Contents

Written evidence submitted by Samantha
Fulstow

I am writing to give my personal experiences of the
Work Capability Assessment (WCA), Atos and the way my claim was
proceed by the DWP Jobcentre plus.

1. I have now undergone two WCA, the first in
2009 and the second in November 2010. Both were carried out by
nurses who I feel did not have adequate knowledge and understanding
of mental health difficulties.

 (i) The
first assessment lasted approximately 20 minutes and I was asked
questions about my physical ability to perform tasks, I was also
asked about any emotional, cognitive or behavioural difficulties.
I answered the questions in as much detail as possible while showing
the assessor documentation to back up what I was saying. I found
a lot of the questions to be very misleading, ie I was asked if
I had an active bank account in which my benefits were paid in
to, I answered yes to this question as my money went in to my
account rather than receiving a giro as I am not very good at
managing my money. My answer to this question was used against
me to say that I had no difficulties managing my finances.

 I
received my results of the WCA and scored zero points, I then
went to appeal and within approximately 15 minutes I was awarded
15 points and was then awarded the full benefit.

 (ii) My
second WCA took place in November 2010, the assessor was a nurse
and the assessment took approximately 30 minutes. I was asked
the same questions relating to physical and mental ability for
completion of tasks and again many misleading question. For example,
I was asked if I see my GP for any treatment, I said that I saw
my GP twice weekly to pick up persecutions and to review my progress
as my GP was in the process of changing my antidepressants as
my old ones had been discontinued. This was used as evidence that
I could cope with social situations as I left the house to do
this. I was asked if I had any contact with friends or family,
I said that my dad came to see me once a week make sure I was
generally ok. This was used against me to show that I could cope
with social situations. I was also asked if I had a bank account
and if I had an address where I received post, this was used as
evidence that I had no difficulties managing my affairs. As I
did last time, I provided evidence to support my claim. The assessor
refused to look at it saying that it wasn't important. This has
been used against me stating that I did not provide supporting
evidence.

 From
the line of questioning in the WCA I feel it is impossible to
get any points for the descriptors because when you try to answer
a question the assessor scrutinises your answers. For example,
when I was asked if I could prepare a meal for myself I explained
about my paranoia with using the cooker and fear of forgetting
it is on and burning food or myself. I added that I used microwave
meals and get take out. The assessor questioned me saying things
like "but you are physically capable aren't you and I'm sure
you could make a sandwich if you really needed to?" I had
to answer yes to this because I am physically capable; it is mental
health reasons that stop me. I scored zero points for this assessment
and I am currently waiting for appeal. I have been told that I
might not be seen until August but my representative is going
to see if I can get seen sooner. I honestly don't know what I
would do if I didn't have help, this has already caused me a huge
amount of stress.

 (iii) I
found the attitude to the assessor from Atos to be very confusing.
On one hand, when I was giving my history my condition and what
caused it, she was very sympathetic, saying that she was very
sorry to hear what I had been through. When I told her that I
was really worried about the outcome of the assessment because
I had failed the last one and had to go to tribunal, she was sympathetic
and said that she understood how traumatic the experience can
be for people with mental health problems but that there was nothing
she could do about it as she is in no way involved in the process.
On other occasions I found her to be very uncaring and felt that
she didn't understand me. I was feeling very nervous at the assessment
and very self conscious so had my hood up, she asked me to take
it down and I explained how I was feeling and that I was sorry,
she was very sharp with me and it upset me. She hardly looked
at me throughout the whole assessment and even provided a description
of me in the written assessment that was inaccurate, in my opinion,
proving that she wasn't paying attention. I explained to her at
the beginning of the assessment that I get very flustered and
find it difficult to put what I mean in to words when I am under
pressure, even after telling her this she was very pushy when
asking questions and seemed to just want to get it done as soon
as possible without taking my needs in to consideration. I would
have appreciated it if she had taken her time more and let me
put more time in to my answers so she could get a better picture.
I have a lot of phobias and beliefs that many people would find
strange when I am having a really bad time, for example, I have
a fear of vomit that stops me being around anyone who might be
sick, I also have a problem with thinking that people are angry
with me so avoid speaking to people on the phone. I felt that
the assessor didn't take these things seriously and many weren't
included in the written assessment. I think things like that should
be looked in to because they do impact my ability to work and
engage in social situations.

 (iv) My
overall experience of the process has and still is very bad. I
strongly feel that the WCA is not fit for purpose and is letting
a lot of people down. This whole thing is causing me a huge amount
of stress which is making my condition worse and as a result I
worry that it will take longer for me to be in a position where
I could get a full time job. Like many people who suffer from
mental health problems and physical problems I want to work, it's
just that at this moment in time I am not ready. I have pushed
myself too hard in the past and kept going with a job when everyone
around me new I was too ill to work just so I didn't have to go
through the system again. Each time I do this I end up in a much
worse position, having a breakdown and having to try and build
myself back up again. Each time I fail a WCA and have to go through
the appeals process it knocks me back further from my goal of
being fit enough to find work in the future. The WCA needs a serious
overhaul, I can only speak from my experiences of going through
it with a mental health problem (GP thinks I have BPD) and it
is not a nice one. My problems are fluctuating, I might be really
happy and hyper one day, not really looking out for myself and
doing stupid things that might get me in to trouble, another day
I might be so low that I can't move and want to kill myself, another
day I might be slightly psychotic and want to hurt myself in strange
ways, it is very rare that I have a day when I am completely ok
and "sane". The WCA needs to take this in to account,
it is not fare if my assessment happens to fall on a day when
I am coping relatively ok and how I feel other times is not taken
into account. I also think that evidence provided by GPs and other
health professionals should be taken in to account. My GP knows
a lot more about what I go through on a regular basis that a nurse
who sees me for 30 minutes. I think it is important for the assessors
to have some background knowledge of the conditions affecting
the claimant they are assessing. It is like getting a random person
off the street to assess someone with a complex neurological condition,
the results aren't going to be accurate. I also think that the
time between assessments needs to change. I had my previous tribunal
in March 2010, I was then called in for another assessment in
November. If the DWP had looked at my records they would have
seen that it would have taken a miracle drug for my condition
to have got better in that time and there are some people who
are being reassessed every three months. This practice wastes
tax payers money, it would be far more efficient for someone from
the DWP to look over the claimants file and assess whether or
not their condition is likely to have changed, for example, if
a claimant has MS or an inoperable brain tumour, the likelihood
of their condition getting better is very slim.

2. From my experience, the decision making process
is not adequate. The decision is only made from the Atos assessment
which is not accurate and the questionnaire that the claimant
has filled in. You should be allowed to submit evidence from medical
professionals to back up your claim. I think the thing that frustrates
me the most is that once a decision has been made that isn't in
your favour, you are told you can submit supporting evidence to
show why you think the decision is wrong but the DWP do not send
you a copy of the report, so you don't know what questions you
are challenging. When I submitted my appeal to be looked at again
I requested a copy of the assessment so I could put together some
good supporting evidence, but after a month I received a letter
saying the decision could not be changes and that I did not send
in any supporting evidence. I had not received a copy of the report
so I feel this was very unfair. It would be nice to at least be
given a chance to defend ourselves. I think it is wrong that if
you request information from the DWP they do not have to send
it to you, how is anyone suppose to put forward a case when they
are not allowed to see what they are challenging. What I would
like to see in the way decisions are made is:

 (i) A
questionnaire that is suitable for all types of illness and disability.
The questions need to be more rounded so that you are not excluded
if your condition doesn't fit a question 100% you are not excluded.
For example: Part one question 11 Staying conscious when awake:
I suffer from dizzy spells and vertigo caused by anxiety so most
of the time when I stand up I get a white fuzz over my eyes and
nearly fall over, this can be hazardous when crossing roads etc.
I had to answer no to this question because it says that it is
specifically for conditions like epilepsy where you have a fit
or blackout or go in to diabetic shock, what I experience is not
on the list. Part two question 18 Going out: In the second part
of this question it asks if you feel you cannot go out even if
someone is with you, you can only answer yes or no. I had to answer
no to this question as I do not feel like that all the time; my
condition varies so there are many times when I feel I cannot
go out without another person with me. The way this question is
worded means that if you have a condition that varies you have
to answer no and therefore, loose points. There are also any questions
that are very misleading, I had someone fill in the questionnaire
for me and they were confused. For example, in part two of the
questionnaire, the questions start off asking if you can do things
with the options usually, it varies from "not" to "very
often", then on question 15 the wording suddenly changes,
asking if you have difficulty doing things with the same options.
For someone who has difficulties filling in forms this tactic
of changing the wording for the question is very unfair and may
lead to any people ticking the wrong box. I am dyslexic so if
it wasn't for the person helping me reread the question just to
make sure, I would have picked the wrong box. There are also only
10 sections for mental health which quite frankly is not enough,
mental health is very complex and cannot be assessed with such
few questions.

 (ii) I
think the WCA needs to be more thorough. People are different
and a condition is not going to affect two different people in
the same way. Some ailments are quite easy to assess, like if
someone is a quadriplegic or is blind, but others are far more
complex and would need a more in-depth assessment. From the side
of mental health I think more time should be given to gain an
accurate history and understanding, also claimants should be given
more time to explain how being in a working environment would
affect them. Variations in mood and behaviour should be looked
at more thoroughly and on an individual basis rather that asking
set questions. I know that the whole thing is done via a computer
program and that is going to be difficult to change but I think
a lot can be done with choosing the right person to carry out
the assessment. If an assessor has got good training with a variety
of mental health conditions, having a good amount of time with
the claimant to properly discuss the way their condition affects
them should aid them in filling in the questions on the system
adequately. From my experience there have been a lot of problems
with the assessor not fully understanding what the claimant is
trying to say and this is worsened with the feeling of being rushed.

 I
don't really want to muddy this up but I truly think that the
assessments need to be carried out by professionals who are unbiased
and are carrying out the assessments to gain an accurate account
of how a claimant is affected by their condition and not more
concerned about numbers and deadlines, as I truly feel that that
is Atos's main focus. I find it very disheartening that Atos healthcare
are using methods for assessment brought forward by Prof Mansel
Aylward, head of research at Unum Provident in Cardiff. This is
the same company that was sued in America in 2002 for $31.7 million
for running "disability denial factories". Again, I
am sorry for bringing this up but it just worries me a lot.

3. I have been through the appeals process twice
now, the first time I was successful and the second is ongoing.
The first time I was quite happy with the way things were run,
I waited about three months for my appeal to be heard and even
when I had difficulties the staff were very helpful and supportive.
I received all the information I asked for in good time and when
my appeal was heard a decision was made very quickly. The people
who heard my appeal were patient and listened to what I had to
say.

The appeal I am going through currently is unfortunately
taking a lot longer; I have been told that this is due to a high
number of appeals being heard at the moment. Although I am having
to wait they were very prompt in sending me all the relevant information
and including details of organisation who I could contact for
help and advice. In all I am happy with the way this is run.